Health & Medical Coordinating Coalition

[Region] | Emergency Coordination Plan

[Region]

Emergency Coordination Plan

[Updated Date]

Plan Template Preparedby

Emergency Preparedness Research, Evaluation & Practice Program

Harvard T.H. Chan School of Public Health

Template Created 2015

Preface

In order to build better prepared and more resilient, communities it is essential that all elements of the health sector must work together to prepare for, respond to, recover from and mitigate against the impacts of major incidents or events, including terrorist attacks, natural disasters and other emergencies that exceed the capacity or capabilities of any single entity.

The role of strong, resilient and prepared Health and Medical Coordinating Coalitions (HMCCs) to facilitate preparedness planning and response at the regional level is critical to providing an effective ESF#8 response across the Commonwealth of Massachusetts.

The regional coalitions - through their multi-disciplinary membership - endeavor to develop and promote emergency preparedness, mitigation, response and recovery capabilities throughout the health sector by:

Strengthening community health sector resiliency
Building relationships within the health sector and across the community
Developing collaborative emergency preparedness, response and recovery plans
Facilitating communication, information and resource sharing
Maximizing the utilization of existing resources

The regional Coalition’s coordination approach enhances health-related response strategies by coordinatingassets from multiple municipal and institutional resources and facilities in an organized regional response.

ASPRhas identified the following eight capabilities(shown with their aligned Hospital Preparedness and Public Health Preparedness capability designation) as the basis for healthcare system, Healthcare Coalition, and healthcare organization preparedness:

1. Healthcare System Preparedness

2. Healthcare System Recovery

3. Emergency Operations Coordination

5. Fatality Management

6. Information Sharing

10. Medical Surge

14. Responder Safety and Health

15. Volunteer Management

This Emergency Coordination Plan is intended to provide a framework for regional coalitions to coordinate response activities across all coalition disciplines in their region.

*This plan template aligns with the Massachusetts Department of Public Health’s All-Hazards Emergency Operations Plan (2014)

Table of Contents

Preface
Table of Contents
1. / Plan Maintenance
1.1 / Verification of Plan Approval
1.2 / Revision Process
1.3 / Change Requests
1.4 / Plan Distribution
1.5 / Record of Changes
2. / Plan Introduction
2.1 / Plan Organization
2.2 / Purpose & Scope
2.3 / Planning Assumptions
2.4 / Roles & Responsibilities
2.5 / Description of Region
3. / Concept of Operations
3.1 / Threat Assessment
3.2 / Notification
3.3 / Response Procedure
4. / Communication
4.1 / Public Communication
4.2 / Partner Communication
4.3 / Internal Coalition Communication
5. / Demobilization
5.1 / Demobilization
5.2 / Evaluation
6. / Appendices
7. / Annexes

Plan Maintenance

1.1 Verification of Plan Approval:

[Who is required to review/approve this plan?]

Name / Position / Date Approved

1.2Revision Process

[Name of Sponsoring Agency], the sponsoring agency for the Health & Medical Coordinating Coalition for [Region] is responsible for ongoing assessment and maintenance of the Coalition’s Emergency Coordination Plan, in collaboration with the coalition’s membership.

This Emergency Coordination Plan (ECP) will be reviewed at least annually and updated as necessary. The ECP may also be modified following an exercise or real event. Following the annual review or any exercise or real event an improvement plan will be drafted based on the assessment, after action reports (AAR) or other documentation or data.

The Coalition may develop hazard specific plans, which will be incorporated as functional annexes to the Base Emergency Coordination Plan. Hazard specific plans will also be updated and maintained annually.

1.3Change Requests

Requests for changes to the Coalition’s Emergency Coordination Plan can be submitted to [where and to whom should changes be submitted]

1.4Plan Distribution

A copy of the Coalition’s Emergency Coordination Plan (and any plan updates) will be distributed to the following people/organizations:

[to whom should the plan (and its updates) be distributed]

1.5Record of Changes

[Name of Sponsoring Agency], the sponsoring agency for the Health & Medical Coordinating Coalition for [Region] is responsible for implementing all changes to the Coalition’s Emergency Coordination Plan, and documenting the distribution of all proposed changes in the Plan’s Record of Changes (below)

Date / Section, Subsection, Page / Description of Change
(e.g., update, amendment, annual review)

2. Plan Introduction

2.1 Plan Organization

The Coalition’s Emergency Coordination Plan consists of three main sections:

The Base Plan provides an overview of the Coalition’s policiesand organization during emergency response and describes the structure and processes of a coordinated approach.

Appendices contain relevant supplemental material to the Base Plan functions that help facilitate emergency response such as contact information, hazard vulnerability analysis and process documentation.

Annexes to the Coalition’s Emergency Coordination Plan provide specific information and direction concerning a particular emergency function or hazard such as Infectious Disease Surveillance or Medical Countermeasure Dispensing.

1.6Purpose & Scope

Purpose:

The Health & Medical Coordinating Coalition for [Region] - through multi-disciplinary membership - endeavors to develop and promote emergency preparedness, mitigation, response and recovery capabilities throughout the health sector by:

Strengthening community health sector resiliency
Building relationships within the health sector and across the community
Developing collaborative emergency preparedness, response and recovery plans
Facilitating communication, information and resource sharing
Maximizing the utilization of existing resources

In times of crisis, such as a health emergency, disaster, or catastrophic incident, the Coalition will perform additional activities above and beyond its normal business efforts.

The Coalition’s Emergency Coordination Plan establishes the organizational framework for the activation and management of Coalition activities in response to incidents or events having public health or healthcare implications.

The Coalition’s Emergency Coordination Plan describes:

The Coalition’s roles and responsibilities in an incident or event.
The decision-making process to activate the Coalition’s Emergency Coordination Plan.
The notification process during an incident of event.
The communication process for Coalition membership during an event.

This Emergency Coordination Plan provides an organizational structure and a concept of operations to guide the Coalition in responses to public health hazards, business interruptions, and threats that arise in any incident or event. The coalition’s responses are not limited to incidents or events occurring within their region. Major disasters, catastrophic incidents, or other large events may result in Emergency Coordination Plan activation, particularly if they occur in neighboring regions or states.

Scope:

The Coalition’s Emergency Coordination Plan is an all-hazards plan that establishes the framework to support local and region activities to:

Mitigate or prevent public health emergencies;
Prepare staff, volunteers, and members of the public to respond and recover from an emergency;
Respond appropriately; and
Recover effectively and efficiently.

The Coalition’s Emergency Coordination Plan includes policies, procedures, and protocols for coordination of health sector information sharing and dissemination; support and technical assistance for disease surveillance, investigation, and control; multi-agency coordination of response activities for large scale emergencies; identification and mobilization of resources within the Coalition’s region; and the facilitation of resource requests from outside of Coalition’s jurisdiction.

The Coalition’s coordination will not supersede the municipal, regional or state emergency operation plans or institutional plans, nor will it direct local agency efforts. Rather, this regional approach enhances health-related response strategies by including assets from multiple municipal and institutional resources and facilities in coordinating a regional response.

1.7Planning Assumptions

Incidents and events are managed at the lowest possible geographic, organizational, and jurisdictional level using anincident management system. An incident is an unplanned situation that can occur at any time with little or no warning and threatens the public’s health, such as a natural disaster, mass casualty event, chemical spill or influenza pandemic. An event is a planned occasion that may have the potential to threaten the public’s health, such as the Boston Marathon, or other large public occasion. Both an incident and event may:

Require significant communications and information sharing across Coalition disciplines
Involve single or multiple geographic areas.
Involve multiple varied hazards or threats on a local, regional, state, or national level.
Affect critical infrastructures and services.
Overwhelm the capacity and capabilities of local and regional organizations/agencies.
Require short-notice resource coordination and response.
Require prolonged, sustained incident management operations and support activities.

The Coalition and its member agencies may have to be able to continue response operations for an extended period of time as dictated by the incident or event.

This Emergency Coordination Plan reflects the additional assumptions and considerations:

The highest priorities of any incident management system are always life/safety for staff, responders, and public health and safety for the population.
The Coalition and its member agencies will support and work in partnership with each other and with local, regional, tribal, state, and federal response efforts.
Some individuals may be more vulnerable to the threats associated with the incident or event and/or may have difficulty accessing the public health and medical services they require.
[add any other region specific planning assumptions here]

The degree of the Coalition’s involvement and/or coordination in a given incident or event will depend largely upon the impact on the public’s health and the health sector’s operations. Other factors that may also affect the degree of the Coalition’s involvement include:

Requests for assistance.
The type or location of the incident or event.
The severity and magnitude of the incident or event.
The need to protect the public’s health.

1.8Roles & Responsibilities

All Coalition member agencies have a role in supporting and participating in the readiness efforts of the Coalition. The following groups have critical responsibilities in Coalition readiness and response:[below is some suggested plan content]

Coalition Sponsoring Agency [Sponsoring Agency Name]

As the coordinating agency for the Regional Healthcare Coalition the Sponsoring Agency is responsible for:

[Insert here the responsibilities of the Coalition’s Sponsoring Agency. Below are some suggested responsibilities:]

Activating the Coalition’s Emergency Coordination Plan
Coordinating a responses of Coalition member agencies
Disseminating information to Coalition member agencies and partner agencies
Managing resource allocation and external resource requests
Report Coalition response activities and challenges

Coalition Leadership Team/Executive Committee:

A leadership team, representative of all Coalition disciplines, which provides overall leadership for the RegionalCoalition. This includes determining strategic priorities, guiding policy on and supporting overall operations of the Coalition.

[Insert here the responsibilities of the Coalition’s Leadership Team – if applicable]

Coalition Leadership Team/Executive Committee Members

HMCC Discipline / Contact / Contact Information
Sponsoring Agency
Hospitals
Public Health
Long Term Care
Community Health Centers
EMS
Emergency Management
[insert other members here]

Coalition Member Agencies:

All Coalition member agencies have their own internal response and/or recovery responsibilities. In order to facilitate Coalition coordination member agencies also have the following responsibilities:

[Insert here the responsibilities of the Coalition’s Member Agencies. Below are some suggested responsibilities:]

Communicate current response activities and situational awareness to the Coalition leadership
Communicate any current or anticipated resource gaps to the Coalition leadership
Communicate any existing resources that may be available to other Coalition members to assist in the community response.

Regional Public Health Coordinator:

[Insert here the responsibilities of Regional Public Health Coordinator]

Regional Hospital Coordinator:

[Insert here the responsibilities of the Regional Hospital Coordinator]

1.9Description of Region

The area covered by the Health & Medical Coordinating Coalitionfor [Name of Region]includes the following towns:

County / Town/City / County / Town/City

Regional Geographical Characteristics

Climate:

[Insert here a brief overview of the climate of the Coalition’s region]

Geography:

[Insert here a brief overview of the geography of the Coalition’s region, including any major rivers, coastline, bodies of water, mountains, flood plains, major urban areas, etc]

Demographics:

[Insert here a brief overview of the demographics of the Coalition’s region, including total population, age, income, linguistic and ethnic demographics]

Transportation:

[Insert here a brief overview of the major transportation features and considerations for the Coalition’s region]

Regional Health Sector Organizations

The following health sector organizations are located in the area covered by this Coalition:

Organization
or Institution / Total Number / Organization
or Institution / Total Number
Hospitals / EMS Services
Specialty Hospitals / Long Term Care Facilities
Transitional Care Hospital / Dialysis Centers
Community Health Centers / Local Public Health Depts
Behavioral Health Facilities / Regional Public Health Orgs
Home Hospice Agencies / VA Facilities
Home Health Care Agencies / Medical Reserve Corps

Concept of Operations

3.1 Threat Assessment

Hazard Vulnerability Assessment

Hazard Vulnerability Assessments (HVA) assist in the prioritization of preparedness efforts by identifying hazards that pose the greatest risk and identifying mitigation strategies to lessen the impact of those risks.

[You may wish to include the full HVA in an appendix to the Emergency Coordination Plan)

Hazard / Encompasses Threat Elements from / Assigned Probability Score
(0 – 5) and Definition
[insert regional specific hazard vulnerability assessment results here]

2.2Notification

Inbound Notification

The Coalition may receive notification and/or situational awareness from the following sources:

Health and Homeland Alert Network (HHAN) notification
Coalition member agency notification
Weather report
Television, internet or radio source
Social media notification
[insert here other ways that the Coalition may receive an inbound notification of an

incident or event]

Inbound Notification Considerations: The Coalition will apply the following considerations to conduct the initial assessment of an inbound notification. These considerations will assist in determining whether the Coalition should take any action on the inbound notification:

Source of the information
Quality and quantity of the information
Severity, magnitude, and timelines regarding the potential or actual health threat or threat of business interruption
Are there multiple cases of a rare or novel illness, or illnesses with an unknown cause?
Is the incident occurring in multiple jurisdictions?
Is the incident causing or likely to cause serious morbidity or mortality?
Is there an association with a large event?
Level and competency of prior testing done to generate the information for public health threats
Other intelligence/information to corroborate or support the information
Anticipated need to provide information to MDPH staff, the public, media, or other response partners
[insert here any other considerations to apply to an inbound notification]

Outbound Notification

The Coalition’s internal outbound notification process describes how the Coalition will communicate information about a developing incident or event to Coalition member agencies and/or partner agencies

Following MDPH notification level protocols[RMC1], there are four notification levels (see below for the internal notification chart):

No Action Needed/Business as Usual (White)
Be Aware (Yellow)
Be Ready (Orange)
Take Action (Red)

[Insert here where initial situation reports from Coalition member agencies should be directed and who is responsible for making the initial determination that a notification is necessary]

Other determinations that will be made at this time are:

The appropriate notification level.
The need for a Coalition response and what actions to take for situations at the notification level of “Be Aware” or higher.
Time intervals for future briefings, reports or updates.
A brief description of the situation.
Notification level determined.
Instructions for action, if any.
Information regarding further briefings or updates.

If the Notification Level is Be Aware (yellow), additional information will be sent out as the situation changes and is assessed. [Who is monitoring the developing situation and who will send out this information?]

If the Notification Level is Be Ready (orange) or Take Action (red), the following decisions must be made [insert here who is responsible for making these decisions and who should be consulted]:

Determine Plan activation, and at what level.
Assign responsibilities.
Establish the time and location for the initial briefing.
[insert here any additional initial actions that should be taken]

Notification Method

[Insert here what methods and systems the Coalition could use to make an outbound notification of a developing incident or event]

The notification message will include the following information:

The nature of the emergency
What are the expectations at this time of the Coalition and its member agencies
What are the actions that Coalition member agencies should be taking at this time
When is the next Coalition briefing

When the threat does not materialize or the response is no longer needed the Coalition will notify all member agencies and partner agenciespreviously notified indicating a return to business as usual.

Internal Notification Chart
*adapted from the MDPH Internal Notification Chart
Notification Level / Indication / Who to Notify / Coalition Status
None / Initial assessment does not warrant further notification. / N/A / No action needed. Business as usual.
Be Aware / Credible but unsubstantiated threat, developing
situation or significant concern that does not immediately impact
Coalition members or the region. /

[insert here who should be notified at this level]

[insert here what actionsthe Coalition should be taken at this level]

Be Ready / Potential threat that may affect Coalitionmembers or the region. /

[insert here who should be notified at this level]

[insert here what actions the Coalition should be taken at this level]

Take Action / Confirmed threat to Coalition members or the region. /

[insert here who should be notified at this level]

[insert here what actions the Coalition should be taken at this level]

2.3Response Procedure